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Maine law to require medical pros conduct insurance reviews

Appeals of an insurance carrier's denial of treatment are now required to be conducted by a board certified, licensed practitioner.
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Stock - Medical insurance application, silver pen and stethoscope. Legal law contract and health insurance concepts.

AUGUSTA, Maine — Insurance companies' medical reviews of patients must be conducted by medical professionals under a new Maine law.

Democratic Gov. Janet Mills signed the proposal into law on Thursday. Mills' office says the new law requires that appeals of a health insurance carrier's denial of health care treatment be conducted by a licensed practitioner who is board certified in the proper specialty.

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Mills says it's important for medical professionals with the same training as a patient's personal doctor conduct the reviews, and not insurance company officials. She says the law will protect families from having to justify a member's need for medical care to "insurance company officials only looking out for the bottom line."

Democratic Sen. Geoff Gratwick, of Bangor, proposed the law change. Gratwick is a retired doctor.

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